Justia Insurance Law Opinion Summaries

Mid-Continent filed a declaratory judgment action seeking a declaration that it did not owe coverage for a judgment assessed against its insured, PSI. The district court ruled that the Cooperation Clause in the policy applied to PSI's third-party claim in the underlying lawsuit and that only parts of the judgment were covered.The Fifth Circuit affirmed in part and held that, regardless of whether the Cooperation Clause applied to affirmative claims, the Cooperation-Clause jury instruction was not an abuse of discretion. The court reversed the district court's conclusion that the Professional Liability Endorsement did not cover the entire judgment and held that it did. View "Mid-Continent Casualty Co. v. Petroleum Solutions, Inc." on Justia Law

The First Circuit affirmed the district court’s grant of summary judgment in favor of a Church on its lawsuit seeking a declaratory judgment that its claim filed pursuant to its property insurance policy with an Insurance Company was improperly denied, holding that ambiguities in the policy resulted in coverage for the collapse of a ceiling in one section of the church.The Insurance Company denied the Church’s claim, citing the “faulty construction” exclusion in the policy. In its complaint, the church argued that the collapse was caused by hidden decay such that the “additional coverage - collapse” provision applied. The First Circuit affirmed, holding that the meaning of “decay” was ambiguous and that ambiguity must be resolved in the Church’s favor. View "Easthampton Congregational Church v. Church Mutual Insurance Co." on Justia Law

The First Circuit affirmed the district court’s grant of summary judgment in favor of Liberty Mutual Insurance Corporation on Brendan Kelly’s claim that Liberty was bound to provide uninsured motorist coverage for his benefit, holding that no uninsured motorist coverage was provided under the policy.The insurance contract was an umbrella policy issued to Kelly’s employer and the named insured and was issued in New Hampshire. The named insured rejected uninsured motorist coverage in writing, but the writing was not incorporated into the policy. Kelly argued that that the lack of an explicit reference to the named insured’s written rejection rendered that rejection inoperative against an additional insured like himself, and that provision of uninsured motorist coverage was therefore required under state law. The First Circuit disagreed, holding that Kelly’s position was not implicit in the statute. View "Kelly v. Liberty Insurance Corp." on Justia Law

Appellants Ryan and Kathryn McFarland owned real property in Garden Valley, Idaho, which feathred three structures insured through Liberty Mutual Insurance Group: a main cabin; a detached garage with an upstairs “bonus room”; and a pump house containing a geothermal well. The policy provided two types of coverage for structures. Coverage A (“Dwelling Coverage”) provided up to $188,500 in coverage for “the dwelling on the ‘residence premises’. . . including structures attached to the dwelling . . .” and Coverage B (“Other Structures Coverage”) provided up to $22,350 for “other structures on the ‘residence premises’ set apart from the dwelling by clear space.” In February 2017, a radiant heater burst in the bonus room and damaged the garage and its contents. After the McFarlands filed a claim, Liberty stated that the damage was covered under the policy. Believing the damage to fall under the Dwelling Coverage, the McFarlands hired contractors to repair the damage. However, after Liberty paid out a total of $23,467.50 in March 2017, Liberty stated that the coverage was exhausted because the damage fell under the Other Structures Coverage. This led the McFarlands to sue, alleging among other claims, breach of contract based on Liberty’s interpretation of the policy. The parties filed cross motions for summary judgment on the issue of whether the damage fell under the Dwelling Coverage or the Other Structures Coverage. Ruling that the policy unambiguously provided coverage for the garage under the Other Structures Coverage, the district court denied the McFarlands’ motion and granted Liberty’s. The McFarlands appealed. Finding that the policy at issue here failed to define the term "dwelling", and the term was reasonably subject to differing interpretations, the Idaho Supreme Court reversed the award of summary judgment and remanded for further proceedings. View "McFarland v. Liberty Insurance Corp" on Justia Law

At issue in this appeal were commercial general liability policy exclusions that barred coverage for damage to “that particular part” of the property on which an insured is performing operations, or which must be repaired or replaced due to the insured’s incorrect work. The Tenth Circuit concluded the phrase “that particular part” was susceptible to more than one reasonable construction: it could refer to the distinct component upon which an insured works or to all parts ultimately impacted by that work. The Court surmised the contract had to then be interpreted consistent with the mutual intent of the parties, with the ambiguity resolved most favorably to the insured and against the insurance carrier. The Court adopted the narrower interpretation of the phrase “that particular part,” under which the exclusion extends only to the distinct components upon which work was performed. This conclusion was contrary to the district court's interpretation, and therefore reversed and remanded for further proceedings. View "MTI v. Employers Insurance Co." on Justia Law

This appeal required the Pennsylvania Supreme Court to determine whether a “household vehicle exclusion” contained in a motor vehicle insurance policy violated Section 1738 of the Motor Vehicle Financial Responsibility Law (“MVFRL”), 75 Pa.C.S. 1738, because the exclusion impermissibly acted as a de facto waiver of stacked uninsured and underinsured motorist (“UM” and “UIM,” respectively) coverages. In 2012, Appellant Brian Gallagher was riding his motorcycle when William Stouffer ran a stop sign in his pickup truck, colliding with Gallagher’s motorcycle, causing Gallagher to suffer severe injuries. At the time of the accident, Gallagher had two insurance policies with GEICO; one included $50,000 of UIM coverage, insured only Gallagher’s motorcycle; the second insured Gallagher’s two automobiles and provided for $100,000 of UIM coverage for each vehicle. Gallagher opted and paid for stacked UM and UIM coverage when purchasing both policies. Stouffer’s insurance coverage was insufficient to compensate Gallagher in full. Consequently, Gallagher filed claims with GEICO seeking stacked UIM benefits under both of his GEICO policies. GEICO paid Gallagher the $50,000 policy limits of UIM coverage available under the Motorcycle Policy, it denied his claim for stacked UIM benefits under the Automobile Policy. GEICO based its decision on a household vehicle exclusion found in an amendment to the Automobile Policy. The exclusion states as follows: “This coverage does not apply to bodily injury while occupying or from being struck by a vehicle owned or leased by you or a relative that is not insured for Underinsured Motorists Coverage under this policy.” According to Gallagher, by denying him stacked UIM coverage based upon the household vehicle exclusion, GEICO was depriving him of the stacked UIM coverage for which he paid. The Pennsylvania Supreme Court held the household vehicle exclusion violated the MVFRL, and vacated the Superior Court’s judgment, reversed the trial court’s order granting summary judgment in favor of GEICO, and remanded to the trial court for further proceedings. View "Gallagher v. GEICO" on Justia Law

The Supreme Court reversed the decision of the court of appeals affirming the district court’s garnishment order in favor of a judgment creditor and her insurer, holding that the insurer demonstrated prejudice as a matter of law from its lack of notice of suit.The policy in this case contained a requirement that the insured inform the insurer of a lawsuit arising out of an otherwise covered automobile accident. After the judgment creditor and her insurer obtained the garnishment order, the court of appeals affirmed. The Supreme Court reversed, holding that the stipulated facts established that the insured breached his notice-of-suit duty under the insurance policy and that the insurer was prejudiced by that breach. View "Geer v. Eby" on Justia Law

Defendant Metropolitan Property and Casualty Insurance Company (Metropolitan), appealed a superior court order partially granting and partially denying its summary judgment motion as well as a cross-motion filed by plaintiff Joseph Santos. Santos held a personal excess liability policy with Metropolitan that included excess underinsured motorist (UIM) coverage. After Metropolitan denied a claim made by Santos for excess UIM benefits after Santos was hurt in a motorcycle accident, he brought this declaratory judgment action. The trial court ruled that Metropolitan was liable to Santos for excess UIM benefits. Metropolitan argued the trial court erred in so holding because Santos’s policy required, as a precondition to receiving excess UIM benefits, that he carry a certain amount of underlying insurance coverage, and Santos did not do so. Santos argued his lack of sufficient underlying coverage allowed Metropolitan to reduce its excess UIM liability but not escape it altogether. Finding no error in the superior court's judgment, the New Hampshire Supreme Court affirmed partial summary judgment. View "Santos v. Metropolitan Property & Casualty Ins. Co." on Justia Law

A Reinsurance Participation Agreement (RPA) executed by AUCRA and Minnieland was an insurance contract under Virginia law. The Fourth Circuit held that the district court did not violate the court's prior mandate by looking at the EquityComp program as a whole; the RPA and insurance policies constituted an integrated transaction and must be read as one contract; and the integrated contract was a contract of insurance under Virginia Code 38.2–312. Finally, the court noted that it was not the first to determine that the program marketed by Applied Underwriters was insurance. View "Minnieland Private Day School v. Applied Underwriters Captive Risk Assurance Co." on Justia Law

Dennis Woolman, former president of The Clemens Coal Company, challenged a district court’s determination that Liberty Mutual Fire Insurance Company didn’t breach a duty to him by failing to procure for Clemens Coal an insurance policy with a black-lung disease endorsement. Clemens Coal operated a surface coal mine until it filed for bankruptcy in 1997. Woolman served as Clemens Coal’s last president before it went bankrupt. Federal law required Clemens Coal to maintain worker’s compensation insurance with a special endorsement covering miners’ black-lung disease benefits. Woolman didn’t personally procure insurance for Clemens Coal but instead delegated that responsibility to an outside consultant. The policy the consultant ultimately purchased for the company did not contain a black-lung-claim endorsement, and it expressly excluded coverage for federal occupational disease claims, such as those arising under the Black Lung Benefits Act (the Act). In 2012, a former Clemens Coal employee, Clayton Spencer, filed a claim with the United States Department of Labor (DOL) against Clemens Coal for benefits under the Act. After some investigation, the DOL advised Woolman that Clemens Coal was uninsured for black-lung-benefits claims as of July 25, 1997 (the last date of Spencer’s employment) and that, without such coverage, Woolman, as Clemens Coal’s president, could be held personally liable. Woolman promptly tendered the claim to Liberty Mutual for a legal defense. Liberty Mutual responded with a reservation-of-rights letter, stating that it hadn’t yet determined coverage for Spencer’s claim but that it would provide a defense during its investigation. Then in a follow-up letter, Liberty Mutual clarified that it would defend Clemens Coal as a company (not Woolman personally) and advised Woolman to retain his own counsel. Liberty Mutual eventually concluded that the insurance policy didn’t cover the black-lung claim, and sued Clemens Coal and Woolman for a declaration to that effect. In his suit, Woolman also challenged the district court’s rejection of his argument that Liberty Mutual should have been estopped from denying black-lung-disease coverage, insisting that he relied on Liberty Mutual to provide such coverage. Having considered the totality of the circumstances, the Tenth Circuit Court of Appeals concluded the district court didn’t err in declining Woolman’s extraordinary request to expand the coverages in the Liberty Mutual policy. “Liberty Mutual never represented it would procure the coverage that Woolman now seeks, and the policy itself clearly excludes such coverage. No other compelling consideration justifies rewriting the agreement— twenty years later—to Woolman’s liking.” View "Liberty Mutual Fire Insurance v. Woolman" on Justia Law